Abstract
ObjectivesTo describe the epidemiological characteristics of patients with spinal metastases between 2007 and 2019.MethodsPatients with spinal metastases were identified from several clinical centers in China between January 2007 and July 2019. Demographics, primary tumor types, spinal involvement, and Clinical indicators of each patient were reviewed.ResultsA total of 1196 patients were included in this study, 717 males (59.95%) and 479 females (40.05%), with a male to female ratio of 1.50:1. Most patients (63.71%) were in the ages range of 50 to 69 years. The mean age was 58.6 ± 11.6 (range 13–89) years and the median age was 59.0 years. The average age of females was younger than that of males, and the difference was statistically significant. The proportion of male patients over 60 years old was higher than that of females, and the difference was statistically significant. The most common primary tumor was lung cancer (n = 437, 36.54%), followed by unknown origin (n = 194, 16.22%), kidney cancer (n = 78, 6.52%), breast cancer (n = 76, 6.35%), and liver/biliary cancer (n = 75, 6.27%). The most common primary tumor was lung cancer in both males and females, followed by unknown origin in males and breast cancer in females. There were 730 patients (61.04%) in the subgroup of the number<3; the highest level was lumbar vertebrae, with 250 patients (34.25%). The remaining 466 patients (38.96%) were included in the subgroup of the number ≥ 3; the highest level was tumor metastasis of multiple‐level of spine, with 334 patients (71.67%). Among the 1196 patients, spinal cord injury occurred in 54.01% of patients, 76.34% of patients developed moderate and above pain, 55.69% of patients had metastatic spinal cord compression, and only 26.67% of patients had a clear history of primary tumors.ConclusionThis study provided a relatively detailed description of epidemiological characteristics in spinal metastases in China, which could assist orthopaedic surgeons to understand the clinical characteristics of spinal metastases, and is of great significance in guiding clinical diagnoses and scientific research.
Highlights
Improvements in clinical anti-tumor multimodality therapies and palliative therapy have prolonged patients’ survival, but the incidence of distant metastasis is still increasing[1]
Inclusion criteria: (i) patients diagnosed with spinal metastases based on clinical symptoms, radiographic examinations, and/or histopathology; (ii) hematological malignancies including myeloma and lymphoma were included; and (iii) patients whose observation indicators could be retrospectively analyzed
Recorded Indicators The following indicators were retrospectively recorded: (i) patient demographics, including age and gender; (ii) primary tumor types; and (iii) spinal involvement, including level and number of involved vertebrae; and (iv) clinical indicators, including Frankel grade, visual analog scale (VAS) for pain, metastatic spinal cord compression (MSCC), and tumor history
Summary
Improvements in clinical anti-tumor multimodality therapies and palliative therapy have prolonged patients’ survival, but the incidence of distant metastasis is still increasing[1]. The vertebral column is the third most frequent metastasis site after the lungs and liver, and accounts for approximately 50% of bone metastases[2–4]. 40% to 70% of patients with advanced neoplasia will eventually develop spinal metastases, and metastatic spinal cord compression (MSCC) will develop in 10% to 20% of these patients[5–7]. Its main clinical manifestations are associated with severe pain and with paralysis, sensory loss, sexual dysfunction, and urinary and fecal incontinency, especially when the neurologic elements are compressed, which are important factors leading to seriously reduced quality of life and even death[8].
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